tbuckley/cabot-search huggingface dataset:
AB1611 INFLAMMATORY ARTHRITIS AND WORK: WHAT PROFESSIONAL ADAPTATIONS?
Authors: A.C. Rat, I. Thaon, D. Loyal
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Despite improvements in the management of inflammatory arthritis (IA), the disease still has a significant impact on work and the support for patients with professional difficulties remains insufficient. The questionnaires currently available to us evaluate the societal impact of impact of IA on work (e.g. productivity at work) but not individual intermediate criteria such as work difficulties or possible adaptations. <h3>Objectives</h3> The objective of the study was to better understand the difficulties encountered at work, the coping strategies used and the motivations of patients with IA to continue working. Only the occupational adaptations are presented here. <h3>Methods</h3> 32 individual semi-directed interviews and 2 group interviews were conducted with patients with IA recruited in consultations or by patient associations. The participants were recruited according to a. purposive sampling with maximum variation. Inclusion criteria were: age 18 to 65 years, have IA, be professionally active, have difficulties or concerns at work due to the disease. The interviews. were conducted with an interview guide and were recorded and transcribed in full. The thematic analyses were conducted using an inductive approach. <h3>Results</h3> The analysis of the adaptations implemented revealed 14 main themes: adaptation of positions, tasks and mobilizations; adaptation of equipment; support from colleagues; change of working time, changing schedules and night work; taking breaks at work, splitting activities; Teleworking; reorientation, training; recognition of the status of disabled worker; occupational medicine, administrative difficulties; ergonomists; trade unions; changing position, jobs or employers. Examples of quotes from the interviews: <h3>Conclusion</h3> Patients discuss multiple possible adaptations, their advantages, disadvantages and difficulties encountered. These data will be useful to occupational health professionals and clinicians in helping patients to keep their jobs in good conditions and develop appropriate services. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Anne-Christine Rat Speakers bureau: Pfizer, Lilly, Sanofi Genzyme, Abbvie, BMS, Galapagos, novartis, Isabelle Thaon: None declared, Deboreh Loyal: None declared.
AB1599 EVALUATING HOW EFFECTIVELY PATIENTS WITH A NEW INFLAMMATORY ARTHRITIS ARE BEING TRIAGED INTO THE APPROPRIATE CLINIC AT A TERTIARY CARE HOSPITAL IN THE UK: A RETROSPECTIVE AUDIT
Authors: A. Vivekanantham, A. Soni, H. Thrower
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Early diagnosis and treatment of inflammatory arthritis (IA) is essential: BSR guidance states patients must be seen within three weeks and started on disease modifying anti-rheumatoid drugs (DMARDs) within six weeks. <h3>Objectives</h3> To evaluate how effectively people referred with a new IA are being triaged, whether national standards are met and analyse variables which may influence triage of patients with new IA. <h3>Methods</h3> A retrospective review was performed of all new patients seen in EIA-clinic and those with new EIA who had been seen in non-EIA clinics from 01/09/21-31/11/21. Data was collected on days' wait from referral to assessment/ commencement of DMARD. We calculated the conversion rate (CR) (percentage of referrals triaged to EIA clinic that have EIA) and detection rate (DR) (percentage of new EIA patients that are seen in the EIA clinic). The standard for CR and DR was 50% and 95%, respectively. We then examined why some new EIA patients were not triaged to the EIA-clinic using information provided on the referral. <h3>Results</h3> Of the patients seen in the EIA-clinic 36/73 had a new diagnosis of an EIA, giving CR of 49%. Of the new diagnoses of EIA made during that time-period 36/53 were appropriately triaged to be seen in the EIA clinic, giving a DR 68%. Patients seen in the EIA clinic had an average of 5 weeks wait from referral to assessment/commencement of DMARD. In contrast, patients who had been seen in non-EIA clinics had an average of 10 weeks from referral to assessment/commencement of DMARD. A previous audit performed before COVID-19 (01/11/19- 01/01/20) showed a CR of 25% (115 patients seen in EIA-clinic, 29 new diagnoses) and a DR of 69% (29 new diagnoses, 20 seen in EIA-clinic). Of the 10 patients with new EIA who were inappropriately triaged to non-EIA clinics did not have pattern of joint involvement or ability to make a fist documented, in comparison to the 38 patients with a new EIA who were appropriately triaged to EIA-clinic. <h3>Conclusion</h3> Patients with EIA, seen in the EIA-clinic, do not meet guidance for review within three weeks but do meet the guidance for starting a DMARD within six weeks. Patients seen outside the EIA-clinic do not meet either of these standards. Only 68% of people with a new EIA are being triaged to be seen in the EIA clinics, highlighting the need to improve the triage process. Compared to the previous audit, the CR has improved whilst the DR has stayed steady. We have identified variables which appear to influence the triage process. Next steps include making some details from the referral compulsory, exploring using data collected from patients electronically to improve the CR/ DR rates, and artificial intelligence informed modelling. <h3>References</h3> N/A. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1515 EPIDEMIOLOGY AND CLINICAL FEATURES OF MUCOCUTANEOUS LESIONS IN BEHÇET’S DISEASE: STUDY FROM A COHORT OF 120 PATIENTS IN A REGION IN NORTHERN SPAIN
Authors: C. Álvarez-Reguera, A. Herrero-Morant, L. Sanchez-Bilbao, D. Martínez-López, J. L. Martín-Varillas, G. Suárez Amorín, R. Demetrio-Pablo, R. Blanco
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Mucocutaneous lesions are one of the most characteristic signs of Behçet's Disease (BD) and are included in different classification criteria <b>[1].</b> <h3>Objectives</h3> To describe the mucocutaneous manifestations and to assess it accordingly to age and sex. <h3>Methods</h3> Descriptive study of a cohort of 120 patients diagnosed with BD from January 1, 1980 to December 31, 2019. Finally, we included 92 patients following the 2014 International Criteria for Behçet's Disease (ICBD) <b>[2].</b> <h3>Results</h3> 92 patients (45 men/ 47 women) had mucocutaneous involvement. Mean age at diagnosis was (36.3±12.6) years. 27 (29.3%) were young adults (&lt;30 years), 61 (66.3%) middle-aged adults (30-60) and 4 (4.3%) elderly adults (&gt;60 years). The most frequent mucocutaneous manifestations were oral ulcers (OU) (n=92, 97.9%), genital ulcers (GU) (n=69, 73.4%), pseudofolliculitis (n=47, 50%), erythema nodosum-like lesions (EN) (n=28, 29.8%) and Raynaud's phenomenon (n=2, 2%). OU, GU, EN-like lesions and Raynaud's phenomenon were more frequent in women. GU and pseudofollicullitis were more frequent in men. No statistical differences were found between sexes (χ<sup>2</sup> test). Pathergy test was positive in 4 patients. Histopathology of EN-like lesions was performed in 5 patients, 3 (60%) showed septal panniculitis and 2 (40%) vasculitis with neutrophil infiltration, which is a typical pathological finding of EN-like lesion in BD [2]. <b>Table 1</b>. Mucocutaneous lesions divided by age groups are represented in <b>Figure 1</b>. <h3>Conclusion</h3> Identifying characteristic mucocutaneous lesions of BD, as OU, GU, pseudofollicullitis and EN-like lesions may allow early diagnosis and treatment of the disease. There were no gender differences in mucocutaneous lesions. <h3>References</h3> [1]Nakamura K et al, Med (Lausanne). 2021 Feb 1; 7:613432. [2]International Team for the Revision of the International Criteria for Behçet's Disease (ITR-ICBD). J Eur Acad Dermatol Venereol. 2014 Mar;28(3):338-47. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Carmen Álvarez-Reguera: None declared, Alba Herrero-Morant: None declared, Lara Sanchez-Bilbao: None declared, David Martínez-López: None declared, José Luis Martín-Varillas Grant/research support from: Abbvie, Pfizer, Janssen, Lilly and Celgene., Guillermo Suárez Amorín: None declared, Rosalía Demetrio-Pablo: None declared, Ricardo Blanco Speakers bureau: AbbVie, Pfizer, Roche, Bristol-Myers, Lilly, Janssen, and MSD. Janssen, and MSD., Grant/research support from: AbbVie, MSD, and Roche.
AB1471 PROSPECTIVE FOLLOW-UP OF THE POST-THROMBOTIC SYNDROME DEVELOPMENT RISK IN PATIENTS WITH VASCULAR BEHÇET’S DISEASE
Authors: A. Aliyeva, K. Abacar, A. Yazici, S. Çelik, T. Ergun, H. Direskeneli, F. Alibaz-Oner
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Deep vein thrombosis (DVT) is the most common form of vascular involvement in Behçet's disease (BD). Post-thrombotic syndrome (PTS) refers to the symptoms and signs of chronic venous insufficiency following DVT. It develops within the first 2 years in more than half of the patients after acute DVT [1]. <h3>Objectives</h3> In this prospective study, we aimed to evaluate the risk of PTS development after DVT and the factors affecting the development and severity of PTS in BD patients. <h3>Methods</h3> BD patients (n=18) with acute DVT and were followed in 3 tertiary rheumatology centers were included in the study. Patients are evaluated for PTS presence during acute DVT, 6-12. months and then annually. Villalta scoring with a total score of &gt;4 or presence of venous ulcer was defined as PTS. PTS was classified as mild if the score was between 5-9, moderate between 10-14, and presence of &gt;14/venous ulcers as severe. Venous Damage Score (VDS) was used to evaluate the effect of venous disease on work productivity and Venous Clinical Severity Score (VCSS) for symptom severity. <h3>Results</h3> The clinical features of the 18 patients included in the study are shown in Table 1. Major-organ involvement was present in 12 patients (pulmonary involvement in 7 (39%), ocular involvement in 5 (28%), arthritis in 3 (13%), neurobehçet and enterobehçet each in 1 patient). Steroid and IS treatment was given to all patients after an acute DVT attack. Additional anticoagulant (AC) treatment was chosen in 16 of the patients. Patients were followed up for a median 23.2 (6-40) months after DVT. The number of patients followed for at least 1 year after an acute DVT attack was 15, and the median follow-up period was 26 (12-40) months. The median duration of AC use in patients who received AC treatment in the follow-up was 6 (0-12) months. PTS developed in 5 (33%) of 15 patients during follow-up. The baseline, 6th and 12th month course of Villalta, VCSS, and VDS scores are shown in figure 1. <h3>Conclusion</h3> In this prospective follow-up after an acute DVT attack 33% of BD patients developed PTS within 1 year. In our previous retrospective study, 62% of 205 patients, half of whom received AK, developed PTS during follow-up [2]. Despite the limitations of our study, such as the low number of patients and the short follow-up period, AC treatment in all patients (except 1) may have influenced a lower PTS development in the prospective follow-up compared to the retrospective data. <h3>References</h3> [1]Baldwin MJ et al. J Thromb Haemost. 2013 May;11(5):795-805. [2]Aksoy Aet al. J Vasc Surg Venous Lymphat Disord 2021; 9:1451. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1484 ADULT-ONSET STILL’S DISEASE AND SYSTEMIC JUVENILE IDIOPATHIC ARTHRITIS: PREDICTORS OF DRUG-FREE REMISSION IN A MONOCENTRIC COHORT
Authors: G. Fontana, F. Crisafulli, M. Frassi, M. Cattalini, F. Franceschini, P. Airò
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Adult-onset Still's disease (AOSD) and Systemic Juvenile Idiopathic Arthritis (SJIA, formerly termed Still's Disease), are rare polygenic autoinflammatory disorders of unknown etiology. The clinical course of AOSD/SJIA has been distinguished into different phenotypes, described on the basis of the evolution of symptoms over time. In a sizeable proportion of affected patients, disease remission can be achieved with treatments, that can be progressively tapered and stopped without relapse. Not much information is available on drug-free remission predictors. <h3>Objectives</h3> To look for drug-free remission predictors in a retrospective monocentric cohort of AOSD/SIJA patients. <h3>Methods</h3> Retrospective evaluation of AOSD/SIJA patients followed up in an Italian Rheumatology Unit between January 1997 and September 2022. All patients fulfilled the Yamaguchi criteria or PRINTO preliminary criteria. Drug-free remission was defined as the absence of clinical and laboratory markers of disease activity and absence of treatment for at least 6 months. Differences between patients who achieved drug-free remission or not were assessed using the using Mann-Whitney test, Student's t-test, Chi-squared test and Fisher test when appropriate. <h3>Results</h3> 57 AOSD and 7 SIJA consecutive patients were included in the study. Drug-free remission was achieved in 23 patients (35.9%) after a median period of 3,62 years (IQR 1,37 – 6). Their main baseline demographic and clinical features, as well as treatment received are summarized in Table 1. Patients in the drug-free remission group more often had white blood cells count &gt;15.000/uL at baseline (p:0.004) than other patients. On the contrary, patients who failed drug-free remission more frequently were treated with Cyclosporine A (CyA) at disease onset (p:0.042). No significant difference was observed when analyzing if treatment with csDMARDs or bDMARDs was started within 3 months of the disease onset or not. <h3>Conclusion</h3> Hyperleukocytosis at baseline was identified as a potential predictor of drug-free remission in our cohort of AOSD/SIJA patients, while this was more difficult to obtain in patients treated with CyA at the disease onset. Larger and collaborative studies are needed to confirm and better define these results. <h3>References</h3> [1]Yamaguchi M et al. J Rheumatol. 1992 Mar;19(3):424-30. PMID: 1578458. [2]Martini A et al. J Rheumatol. 2019 Feb;46(2):190-197. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Giulia Fontana: None declared, Francesca Crisafulli: None declared, Micol Frassi Speakers bureau: Novartis, Lilly, marco Cattalini Consultant of: SOBI, Novartis, Franco Franceschini: None declared, Paolo Airò Speakers bureau: Bristol Myers Squibb, Bohringer Ingelheim, Consultant of: Bristol Myers Squibb, Bohringer Ingelheim,
AB0899 RITUXIMAB IN INFLAMMATORY MYOPATHIES: A SINGLE CENTER EXPERIENCE
Authors: A. C. Costi, C. Pena, R. Aguila Maldonado, M. A. Pera, M. García
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Rituximab (RTX) is currently the most widely used biologic agent in the treatment of IIM. The main indications for treatment with RTX in IIM are refractory muscle, lung, and skin involvement. There is growing evidence that biologic therapy in IIM has the potential to benefit patients with refractory disease. (1) <h3>Objectives</h3> Describe and analyze the clinical indications for RTX in a cohort of patients with IIM. Describe adverse effects associated with RTX and clinical response to RTX. <h3>Methods</h3> Descriptive, retrospective study, in a single center of patients diagnosed with IIM (Bohan and Peter-ACR/EULAR 2017), who received RTX (1993 to 2022). Patients with follow-up of at least 6 months after first infusion of RTX were included. The following variables were considered: myopathy subtype, clinical manifestations, RTX indication, RTX administration regimen, and adverse events. Significant clinical response to RTX was defined as improvement in organ function or symptoms, or halting of disease progression, or prevention of relapses, such that the patient did not require further immunosuppression or was maintained on stable immunosuppressive therapy, and no more than 10 mg prednisolone/day or additional doses of RTX were given to treat disease relapses or to maintain initial clinical benefit. <h3>Results</h3> Of 138 patients registered with MMII, 17 (12.3%) patients received treatment with RTX. Fourteen (14) patients (10.4%) were included in the analysis. Table 1 describes demographics and clinical characteristics. The main reason for indication was refractory disease (50%) (Table 2). One hundred percent (100%) of patients received glucocorticoids during RTX use at an average daily dose of 25 mg. Methotrexate was co-administered with RTX in the majority of patients and was also the most widely used drug before RTX. Regarding safety, 5 infectious adverse effects (35%) were recorded in 4 patients (28%), 3 of which were deemed as serious (21%). The clinical response to RXT at 3 months was 78.5%, and 71 % at 6 months. <h3>Conclusion</h3> In this cohort of patients with IIM, 12.3% received treatment with RTX and the main indications were dysphagia and refractory disease. Adverse effects were recorded in 28% of the cases, all infectious, of which 21% were serious. Clinical response was obtained in 78.5% 3 months after the first indication of rituximab, which was maintained in 71% of the patients at 6 months. <h3>Reference</h3> [1]Rituximab Clin Exp Rheumatol. 2017 May-Jun;35(3):512-515. Epub 2016 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1259 SERUM IRON LEVELS WERE POSITIVELY ASSOCIATED WITH THE RISK OF HYPERURICEMIA: NHANES 1999-2014
Authors: S. X. Hu, H. Lin, N. Chen, Q. H. Li
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Increasing evidence proofs that serum ferritin plays an important role in the development of hyperuricemia (HUA), however, few studies focus on the relationship between serum iron and serum urate (sUA). <h3>Objectives</h3> To examine the relationship between serum iron and serum urate as well as the risk of HUA classified by gender in the US adult population. <h3>Methods</h3> The present cross-sectional study pooled data from 1999 to 2014 National Health and Nutrition Examination Survey (NHANES). The association between serum iron quartiles and hyperuricemia was evaluated by logistic regression. The restricted cubic spline regression was performed to analyze the association between continuous serum iron and sUA. <h3>Results</h3> The study enrolled 25757 participants in total from 1999-2014 annual NHANES cycles. The crude prevalence of hyperuricemia was 11.9%. Serum iron was significantly higher in those with HUA than in those without HUA (16.6μg/dl vs 15.6μg/dl, p&lt;0.0001). Logistic regression showed that serum iron levels were positively associated with the risk of HUA in the whole participants and male participants after adjusting for age, BMI and eGFR (Table 1). A dose-response association was observed in the whole participants (P for trend &lt; 0.05). The restricted cubic spline regression analysis showed that the association between continuous serum iron and sUA was different in male participants and female participants (Figure 1). The curve of male participants showed an increasing trend (folding point 13.3μg/dl, P=0.033), while for women, sUA first increased linearly, but after the folding point (6.6μg/dl, P&lt;0.001) the curve flattened out and the increasing trend was not significant. <h3>Conclusion</h3> Serum iron levels were positively associated with the risk of HUA in men. The correlation between serum iron and serum uric acid was influenced by gender. More studies are needed to confirm this relationship and to find out the mechanisms behind as well as the reasons for the gender differences. <h3>Reference</h3> [1]Li X, He T, Yu K, Lu Q, Alkasir R, Guo G, Xue Y. Markers of Iron Status Are Associated with Risk of Hyperuricemia among Chinese Adults: Nationwide Population-Based Study. Nutrients. 2018 Feb 9;10(2):191. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1275 NEISSERIA GONORRHOEAE ARTHRITIS: A GROWING PROBLEM
Authors: P. Andújar-Brazal, E. Flores-Fernández, C. Valera-Ribera, I. Vázquez-Gómez, E. Valls-Pascual, J. J. Alegre Sancho
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> <i>Neisseria Gonorrhoeae</i> infection (commonly gonococcus) have increased in recent years. Additionally, an increase in the antibiotic-resistance of the bacteria has been detected, including broad-spectrum cephalosporins, which could lead to untreatable complications like arthritis. <h3>Objectives</h3> The goal of this study is to describe the gonococcal arthritis events identified in a Rheumatology service between 2008 and 2022. <h3>Methods</h3> Retrospective longitudinal observational study based on the review of the medical records of patients diagnosed with gonococcal arthritis in the Rheumatology Department of the Doctor Peset University Hospital in Valencia (Spain) since 2008 to 2022. Sociodemographic and clinical variables, antibiotic sensitivity profile and antibiotic therapy used were studied. Evolution of infections were also analyzed. <h3>Results</h3> Eight cases of gonococcal arthritis were recorded in the period analyzed, all of them diagnosed between the years 2021-2022. All patients except one were male. Half of the patients had sexual transmitted infection history, 75% of which were syphilis infected and 25% had previous hepatitis B infection. The most common form of presentation was oligoarthritis. In three cases a component of tenosynovitis was also observed. Diagnostic arthrocentesis was performed in seven of eight cases and a high profitability of synovial fluid culture was observed (only in one patient bacteria was not isolated). All infections showed cephalosporin and azithromycin sensitivity, all of them displayed a favorable evolution (Table 1). <h3>Conclusion</h3> An increase in gonococcal arthritis cases has been detected in the Rheumatology Department of the Doctor Peset University Hospital in the last two years, overlapping with the end of the social restrictions caused by the COVID-19 pandemic. Despite having described in recent years a growing increase antibiotic resistance, in our study the antibiotic sensitivity profiles were favorable without isolating strains resistant to cephalosporins or azithromycin. <h3>References</h3> [1]Barberá MJ, Serra-Pladevall J. Gonococcal infection: An unresolved problem. Enferm Infecc Microbiol Clin (Engl Ed). 2019 Aug-Sep;37(7):458-466. doi: 10.1016/j.eimc.2018.12.008. [2]Unidad de vigilancia de VIH, ITS y hepatitis B y C. Vigilancia epidemiológica de las infecciones de transmisión sexual, 2019. Centro Nacional de Epidemiología, Instituto de Salud Carlos III/Plan Nacional sobre el Sida, Dirección General de Salud Pública; 2021. <h3>Acknowledgements</h3> Dr. Alida Taberner Cortés for reviewing the article. <h3>Disclosure of Interests</h3> None Declared.